| NPI | 1154985182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 66175) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 66175) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AZ 66175) | |
| 208D00000X General Practice (Licence: AZ 66175) | |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2024-09-05 |